Category: Cancer Update

31 August 2o23

Yesterday, Casey informed me she was going to inject me with Filgastim to stimulate white blood cell production. Apparently my levels were low enough for concern. She gave me the first injection just as I was about to leave and then scheduled me for another on Thursday and another on Friday. All of this was under Dr. Arnaout’s direction but I think that was simply because he was the attending physician. I certainly don’t want him to take over my care. I’ll do the second injection after I visit Dr. Burgers tomorrow. I’ll also be back on a Claritin regimen. The Filgastim causes bone pain and Holy Cross did a study where Claritin mitigated the pain.

As I mentioned yesterday, I hadn’t eaten since breakfast and I walked out of the infusion center at 6 pm. On the way home I stopped at J. Alexanders and ordered there prime rib with baked potato. It was OK but again, the taste just isn’t there. I probably would have been better off with a hamburger and would have been much better off price wise. With tip, it was $56. I’m really surprised restaurants can stay in business with the difficulty in hiring staff, the cost of food on their end and the cost of food for the consumer.

I got a call around 8 am this morning about my second Filgastim shot. They said walk in any time before or after my appointment with Dr. Burgers. Out of my way to Dr. Burgers (but to kill some time) I got my prescription for the remainder of the Budesonide from Walgreens. From Walgreens, it was a short trip to I-95 and the Cancer Center off Commercial Blvd. I was early because the traffic flow on I-95 was not at a standstill.

The second shot went quickly enough and I had an hour to kill before Dr. Burger’s appointment. I simply went to her sitting room and waited and played Solitaire on my phone. Lorraine called me in and when Dr. Burgers came in, she examined the scar, checked for puffiness or swelling and gave me the good news. I can go back to yoga and swimming! She even mentioned in her review notes on the Holy Cross app that I was happy to get back to the water.

The one question I had was “What comes next?” After the chemo treatments, how do I know I don’t come down with cancer again in some form. She said I would undergo periodic examinations by her (every six months after chemo) and that Dr. Velez uses the new blood test that tests for a variety of cancers.

One company is Galleri. Another is by OneTest. I certainly like the idea of a simple blood test to detect multiple cancers. Particularly since my breast cancer was a very aggressive form. Since I’m still on chemo, she still wanted to see me in 4 months.

From the Cancer Center, I headed to the post office to mail off some packages. It’s at the back of a mall near Holy Cross and the mall had a Subway shop so I stopped there for a sub to take home for lunch. Then it was a stop at Whole Foods for a few groceries. It was not my usual Whole Foods but it was on the route home. One thing I always look for are fresh flowers and what caught my eye was a bundle of gladiolas. I haven’t seen them in ages.

Hiding at the base of the gladiolas are a four pack of hazelnut chocolate croissants. I couldn’t resist them. Whatever is going on with my taste buds has not affected the sweet ones. I was good though and bought a lot of fresh fruit (watermelon that tastes like watermelon, cantelope that tastes like cantelope, blueberries, and even some plums. I do try to eat well dietetically, but it’s really hard when you don’t have the appetite for most foods. For example, it’ll be a long time before I order prime rib again and not because of the price.

By the way, the sound bar I added to the tv does work marginally better. The sound is of a better quality than the tv speakers. However, I’m not sure anything will help elucidate Scottish dialect.

Stay tuned!

28 August 2023

I’ve been gassy before but not like last night. Not with diarrhea at the same time. The only thing I can think that caused it was the new prescription of Budesonide. I was busy on the toilet until 11 pm. Then it was toss and turn scared it would return any moment. I finally drifted off around midnight. Then I waked at 4:30 am and ready to go. I figure I need to leave for my appointment with Dr. Velez around 8:15-8:20. There’s no telling what traffic will be like and on a good day it takes around 20-30 minutes. I-95 always keeps you guessing.

I’ve made a ham sandwich, sliced some apples, and have a supply of Tootsie Rolls to hold me for every how long they keep me. The schedule has me for 3 hours but the first infusion ran to 6 hours. Part of the reason was the nausea I had with the Taxol. I took my anti-nausea medicine last night (I barely remembered it) so I should be good for the first part of the infusion with Herceptin.

9:30 am. I didn’t need to be at Holy Cross for the 9:05 am appointment with Dr. Velez. He schedules it in case but he’ll always come see me during the infusion. They took me back exactly at 9:30 am for the infusion. I keep getting more and more information. Today is only Taxol and not Herceptin. I’m on a 3 week schedule with Herceptin for a total of one year. Taxol will be every week for nine weeks.

Around 10 am Dr. Velez stopped by. We discussed my diarrhea and agreed to keep on the Imodium double dose until the diarrhea abates and then cut back to the normal dose. He also said to keep taking the Budesonide for at least a week. He listened to my bowels with his stethoscope and even palpated my abdomen. It’s a good thing he didn’t listen to them last night. It was like a thunderstorm going off inside of me. He continued to reinforce to keep him posted on my condition via text and to keep an eye on my blood sugar (189).

Jullianne is my nurse again. She’s got a great attitude and is seemingly always up. The first thing is to insert the IV into my port and then clear the port. Next comes a blood draw. She always says it takes an hour for the blood test to come back but it was already in my mail box 30 minutes later. She also let me know the Taxol would take about 1 1/2 hours and I’m waiting for her to start it up.

They ran three blood tests this morning: Comprehensive Metabolic Panel, CBC with Differential and for some reason Dr. Arnaout did a magnesium test. That’s peculiar – not the test – but that he’s no longer my doctor.

The Comprehensive Metabolic Panel tests 19 different parameters.

Test	Function	Normal Range	My Results
Sodium	Determines too much or too little in blood	136-145 moles/L	143
Potassium	Electrolyte in blood	3.5-5.1 moles/L	4.4
Chloride	Electrolyte in blood	96-106 milliequivalents/L	109
CO2	Affects respiration	21-31 mmol/L	26
Anion Gap	Determines acid/base of blood	5-15	8
Glucose	Sugar in blood	74-109 mg/dL	184
BUN (Blood Urea Nitrogen)	Blood Urea Nitrogen in blood	7-25 mg/dL	13
Creatinine	Measures kidney function	0.70-1.30 mg/dL	1.10
eGFR (estimated Glomerular Filtration Rate)	Estimated glomerular filtration rate has a read on kidney health	>=60mL/min/1.73m2	70
BUN/Creatinine Ratio	High means not enough blood flow to kidneys	6.0-20.0	11.8
Calcium	Affects bone, kidneys, parathyroid	8.6-10.3mg/dL	9.1
AST (SGOT) – Aspartate Transaminase; Serum Glutamic Oxaloaceate Transaminase	Glutamic-oxaloacetic transaminase (liver function monitor)	13-39 unit/L	20
ALT (SGPT) – Alanine Transaminase; Serum Glutamic Pyruvic Transaminase	Alanine aminotransferase (liver function)	7-52 unit/L	21
Alkaline Phosphatase	Monitor for liver and bone disease	34-104 unit/L	63
Total Protein	Measures albumin and globulin. High levels indicate infection	6.4-8.9 g/dL	6.8
Globulin, Total	High levels indicate infection	1.4-3.9 g/dL	2.6
A/G Ratio (Albumin/Globulin)	Albumin compared to globulin.	>1.0	1.6
Total Bilirubin	Liver function	0.3-1.0 mg/dL	0.5
Albumin	High levels indicate infection	3.5-5.7 g/dL	4.2

CBC (Complete Blood Count) with Auto Differential

Test	Function	Normal Range	My Results
WBC	White blood cells – measures leucocytes, a function of immunity	4.5-11.0K/mcL	5.3
RBC	Red blood cells – determine amount of oxygen in blood	4.30-6.20 M/mcL	3.77
Hemoglobin	Indicator of amount of oxygen in blood	14.0-18.0 g/dL	11.3
Hematocrit	How much of your blood is red blood cells	39.0-55.0%	33.8
MCV (Mean Corpuscular Volume	Average size of your red blood cells	80-100.0 FL	89.5
MCH (Mean Corpuscular Hemoglobin	Amount of hemoglobin, thus oxygen carrying capacity	27.0-34.0 pct	29.9
MCHC (Mean Corpuscular Hemoglobin Concentration	Measures bloods ability to carry oxygen	31.0-37.0g/dL	33.4
RDW (Red Blood Cell Distribution)	Red cell distribution compares volume with size or red blood cells	12.0-15.0%	12.5
Platelets	Count of platelets which affects ability for blood to clot	130-400 K/mcL	229
Lymphocytes relative	Measures relative amounts of B and T cells (immunity)	15.0-40.0%	8.9
Neutrophils, relative	Tells you your body is under stress	40.0-65.0%	88.6
MPV (Mean Platelet Volume)	Measures average size of platelets	6.2-12.1 FL	8.8
Monocytes, relative	Measures amount of this white blood cell (immunity)	1.0-10.0%	2.2
Eosinophls relative	Measures of amount of white blood cells (immunity)	0.0-4.0%	0.1
Basophils, relative	Measures amount for infection/parasites	0.0-2.0%	0.2
Neutrophils absolute	Specific amount of this white blood cell in your body	1.80-7.70K/mcL	4.70
Lymphocytes absolute	Specific amount of this white blood cell in your body	1.o0-4.00 K/mcL	0.50
Monocytes absolute	Specific amount of this white blood cell in your body	0.20-1.00 K/mcL	0.10
Eosinophils absolute	Specific amount of this white blood cell in your body	0.00-0.69 K/mcL	0.00
Basophils absolute	Specific amount of this white blood cell in your body	0.00-0.19K/mcL	0.00
NRBC (Nucleated Red Blood Cell)	Rbc’s are typically enucleate – high values are signs of infections/diseases, cancer	0.0-0.9%	0.1

Magnesium

The magnesium normal is 1.0=2.7 mg/dL. Mine is 1.5, so it was low. It indicates weakness, irritability, abnormal heart rhythm, nausea and/or diarrhoea, or if you have abnormal calcium or potassium levels.

Regardless of the out of wack levels, everything seems to be OK to proceed with the therapy. First up was magnesium. It’ll take about an hour and then 1 1/2 hours for the Taxol. If no nausea, I should be out of here by 2 or 3 pm. I seem to be doing a consistent 5-6 hours at this place. Good thing the people are nice.

The pro-drug cocktail administered first was the usual suspects. Something for nausea )Dexamethazone) something to line my stomach (Pepside) Benadryl to offset the effects of Taxol and Zofram (another anti-nausea drug). Benadryl makes me sleepy so I cranked the chair back and immediately popped out the needle in my port. The IV lines got caught in the arm of the chair.

A nurse came and immediately asked if I got any of the solution on me. I couldn’t detect any. I imagine it would be classified as a chemical spill for them. It would be just like me to have to call a hazmat team and shut the facility down.

They replaced the IV with a new needle and line and I’m back on schedule. Jullianne started the Taxol very slowly – I suspect because of the nausea the previous time and that prevented any real spill. I was watching the Taxol IV and it was dripping once every 18 seconds. You can program the drip to speed up after a period of time and now I’m racing along at a drop every 6 seconds.

The PA system is hooked into the main hospital across the street. Today we’ve had a potential stroke in one of the rooms of the hospital and we’ve had an emergency in the infusion center (other side of me) for some reason. It’s interesting what is broadcast for everyone to hear.

The IV sounded the alarm that Taxol had finished at 1:59 pm. Now to get unhooked and drive home. I’m also waiting for a call from Walgreens to pick up the remainder of the prescription. There was no nausea with the Taxol this time!

Dr. Velez has already scheduled me for a hydration infusion on Wednesday at 3:30 pm. I hope I don’t have chem fog again and miss it.

Stay tuned!

26 August 2023

Ugh! What a night. It went something like this.

25 August 2023
8 pm diarrhea
10:43 p diarrhea took two Imodium AD
11:03 pm diarrhea 

26 August 2023
12:17 am diarrhea 
2:17 am two Imodium AD
2:39 am diarrhea
6:39 am two Imodium AD
8:20 am diarrhea

I texted Dr. Velez to let him know I’m back on the two Imodium AD every four hours and that I’ll see him Monday morning. I’m pretty exhausted from overdoing it yesterday in the yard and add on top of that getting up every few hours with diarrhea, I don’t think I’m getting much done today. I’ll try to change the sheets and wash a load of clothes but I think house cleaning is going by the wayside. I didn’t even consider a walk this morning.

I had no appetite last night. Finally, around 8 pm I had some ice cream (two scoops of coffee, two scoops of chocolate) and that was pretty much it.

Another strange phenomenon is I seem to be getting pangs all over my body. I kind of equate it to a flash of pain in one location that may go on for a few minutes and then move to another area of the body. There doesn’t seem to be any rhyme or reason to it and Advil didn’t help it the other night. Also, my joints ache, particularly the joints of my hand. If I cross my legs in bed, my toes go numb. I’m falling apart.

I’m searching for anything I can eat. Most anything I think of, I don’t want. I have a pot of dried black-eyed peas going on the stove at the moment. Why I think I can eat those, I have no idea but I got a craving for them the other day and made sure I bought some at the grocery. Any port in a storm. Of course, I’ll get gassy with the peas to add to the diarrhea.

Just think! I have only eight more weeks of the two drug regimen!

Dr. Velez just texted back to “Keep up with it.” Not that I have a choice. He suggested he will prescribe another pill called Budesonide which is a steroidal anti-inflammatory for the colon. He’ll send it over as soon as he gets computer access. Pretty soon and I’ll be able to open my own pharmacy. There goes my morning grapefruit. I’ll miss that.

With all the drugs, I’m not sure my body knows what “normal” is any more. The Imodium AD dosage gives me the jitters. I’ll be curious to see that the next chemo round does to me. One hope I do have is Thursday Dr. Burgers may clear me for yoga and swimming. If yesterday taught me anything, it’s I need to work on building my stamina.

Stay tuned!

23 August 2023

Looks like the 6% chance of diarrhea with the Taxol dose I’m on kicked in. I was up at 5:30 am and have been back 6 times. I texted Dr. Velez and he immediately responded. I told him and that I would be in for the 3:30 pm hydration infusion. He said he would stop by and check on me then. He reinforced I needed to take 2 Imodium every 4 hours. My next round will be at 11:45 am.

In the meantime, Salvador dropped off materials to repair my fence. While Chad had to tear out my west wall due to termites and rot (during the flood repair) the gate to the fence at that end started to fall apart. His crew did their best to put a temporary fix to it but I knew more needed to be done.

In addition, the second gate on that section of fence (a double gate) had a 6×6 that was rotting at the top and I knew it was only a matter of time before that went. When Ariel Reyes was trimming my palms, I asked if he knew anyone that could do fence work and he recommended Salvador.

Salvador told me he would do it for approximately $100 and the cost of materials. I asked if he needed a deposit and he said no. He would provide me a receipt for materials from Home Depot. He’ll be back tomorrow to work on the fence. It’s quite an undertaking because he’ll have to jackhammer the concrete away from the 6×6 and replace it and concrete that into the ground. I assume he’ll have to remove the gate. The smaller gate closer to the house will entail removing the gate and the panels of the fence and replacing a 2×4 to which the panels are attached.

The fence has lasted a while. I had it put in in 2014 at a cost of $6567. After nine years, you’d expect a little rot. Samada Fence, Inc. installed it and the guy told me the panels were not a problem but the posts would often rot at the ground. When I painted the fence, I spent extra time painting the top of each post to try to stave off rot but looks like I missed a few spots. Of course, now I’ll have to see if I have any of that stain left around to paint the new posts, 2×4’s and panels. Or, I could just let it weather.

It’s beginning to look like I need to make an investment in Imodium AD. After today’s hydration infusion, I’ll stop at Walgreens and probably clear out their section.

Best laid plans…. I decided to go to Walgreens early and get the Imodium before the infusion. I got a bargain. There was buy 1 get 1 free and it was the Walgreens brand which was $6 cheaper than the brand name. I walked out with 6 packs of 24 tabs each.

I drove back home and was waiting for time to leave for the infusion. Somehow, I got confused about what the time was and when I got up to leave for the infusion, I thought it was 2:45. No, it was 3:45, 15 minutes past my appointment. I have no idea how that happened.

I texted Dr. Velez and he suggested the routine of 2 tabs of Imodium every four hours until there was no diarrhea for 12-24 hours. I hate missing appointments. It goes back to my teaching days and as an undergraduate running between buildings to get to class. He may reschedule the infusion but I have another chemo on Monday, so I’ll find out for sure then.

Stay tuned!

22 August 2023

I had a great night’s sleep. That could partly be due to the Xanax but any port in a storm. I seem to weathered the first chemotherapy session. Strangely, after they hooked me up to the Herceptin yesterday, I had a lot of restless leg syndrome. I couldn’t keep them still nor from stretching out. I was worried it would follow me home but after they finished the Taxol infusion, the legs calmed down. I normally get restless leg at night when in bed, so maybe the Xanax helped with that also.

The next 3 or 4 days will tell how well I’ve adjusted to the new regimen. When I went to the first session in June with 4 drugs, the nurse told me day 3 would be my worse day. It turned out to be day 2 -4 and then the hospital stay.

Again, I’m impressed with Dr. Velez. He reread my blood work and was concerned my glucose level was 190. He texted me yesterday afternoon about that and I explained that was an anomaly for that morning. I sent him a photo of my glucose levels for the past week which were in the normal range and he seemed mollified. Again, Dr. Burgers and Dr. Velez go the extra mile and call or text you at home. Today, my glucose hit 219 but I knew it would be high since one of the premeds they gave me before the infusion yesterday was a steroid. That always sends my glucose out of wack.

I’m scheduled tomorrow to go in at 3:30 for a hydration infusion. I’ve been given the option of canceling if I don’t feel it necessary but I think I’ll do it anyway. I drink plenty of water during the day, but I also did with the first infusion in June and still ended up in the hospital. Better safe than sorry. I was told it would take about 2 hours for the hydration. It’s not like I have a lot to do anyway.

I was feeling well enough to day to do one of my longer morning walks, 1.8 miles along Riverland Road. My cousin Jimmie gifted me a portable neck fan and I wore that for the second time today. I got a late start (9 am) and I knew the temperature and humidity was rapidly climbing. It seemed to work pretty well in keeping the sweat down on my head and neck.

This week I’ve been busy putting together my 2024 calendars that feature photos from my trips. I also received all the note cards I ordered and managed to put them together in sets of 10 and presented five of them to the nurses and staff of the cancer surgical group as a thank you. I don’t know when I’ve been treated so well or with so much empathy by the medical profession. I also think I’m a little bit of an anomaly being a male cancer patient. Dr. Burgers told me I was her fourth in all the years she’s been practicing. I’ve got a follow up with her on the 31st and I plan to ask if I can get back to my yoga stretches and swimming.

I’ve started using the cocoa butter/shea butter solution on the mastectomy scar. I don’t think it’s doing anything to mitigate the scaring but it seems to be loosening up the skin in the area that gives the pulling sensation. The insertion for the drain seems to have closed up and I haven’t leaked on the sheets or the tee shirts once. Again, I was able to sleep a while on my left side again. There does seem to be some light at the end of the tunnel and I haven’t heard a train whistle yet.

I was going to go to Costco today, renew my membership and do a little shopping but after thinking about it, I have everything I need and if I bought something, I have no place to store it in the house. I need to do a purge of stuff around that I haven’t used in a while. For example, I seldom wear long-sleeved shirts these days since I’m not teaching and I can throw out a bunch and keep a few for cooler days.

Mother and Dad moved so much when I was a kid, I learned not to accumulate stuff. However, I’ve lived in this house starting my 28th year and things tend to accumulate whether you want them to or not. I did get rid of a lot of stuff when the house flooded but it could do with some more purging.

Thank goodness I won’t have to worry about that when I pass on. My lawyer is in charge of my estate and his son is an estate salesman. They will take care of everything (for a price, of course) but at least I won’t have to worry friends and family with going through years of junk. Not that I plan on kicking the bucket any time soon.

My next infusion of Herceptin and Taxol is Monday, the 28th, again at 9:30 am. I was so early this last time, I may try to sleep a little later than 5:30 am.

Stay tuned!

21 August 2023

I set me alarm for 6 am but I was out of bed at 5:30 am. You never can tell how traffic will be on I-95 so I wanted to get a head start on my day. Breakfast was water watermelon and blueberries with yogurt. With two cups of coffee, crossword worked, and bag packed, I headed out the door at 8:40 am for a 9:15 “arrive by” time. They called me in for the infusion at 9:35 am.

My nurse is Jullianne and she’s very efficient (and overworked with 5 patients today). There was some confusion as to whether I would receive only Taxol today so she zipped an email to Dr. Velez who, after the blood draw, appeared at my chair side. He explained that it would be Taxol first and then Herceptin today. I’ll do that 9 weeks and then be on Herceptin only for the remainder of a year’s time. I’m glad I checked.

Dr. Velez went above and beyond, explaining how careful he is being to make sure I won’t have trouble with diarrhea. He told me to take Imodium 2 tabs at a time, every 4 hours and keep up with the Lomotil twice a day. He scheduled another appointment earlier for next Monday in case I need a solution to prevent dehydration but said if my stools were not watery, I could cancel the appointment. He indicated that with the four drug regimen I was given, there was a 60% chance of diarrhea. On the two drug regimen I am on, it drops to 6%. I’m on board with that.

Then he gave me his personal cell number to text him with any questions. Very few physicians will go that extra distance. I like the way he works.

My blood work was a mixed bag but nothing that would prevent me from receiving the infusion. My eGFR which tests kidney issues was back to normal so that’s a relief. I can testify my kidneys work quite well. It’s only 12:30 pm and I’ve been to the toilet four times since I’ve arrived. I would blame it on the coffee they provided me but I also suspect it’s the Ringer’s solution along with the infusions.

My sodium level was low, my glucose was high (190) but I had eaten breakfast) my red blood cell (RBC) count was low, hemaglobin low(anemic) and hematocrit low (anemic). This may explain my lack of energy.

My neutrophil relative was high which means my body is fighting an infection (could be the result of the Klebsiella infection) and the lymphocyte relative was low (infection). In addition the neutrophils absolute level was high which leads to high white blood cell (WBC) count and lymphocyte absolute was low which means I’m at a higher risk of infection.

At 10:50 am, Jullianne administered Decadron (Dexamethasome) to prevent nausea and waited 15 minutes. Then I was administered Benadryl (to mitigate any bad reactions I may have to Taxol) then Zofran (anti-nausea) and Pepsid to coat my stomach. The Decadron was an injection into the port as well as the other drugs.

At 12:35 pm, I’m receiving Herceptin (250 ml bag). Jullianne will wait 15 minutes after that infusion before administering the Taxol (250 ml bag). The Herceptin should be 30 minutes since I’ve previously been exposed to the drug.

Jullianne programed the Taxol at 25% of the normal rate of flow for 30 minutes, then 50% for 30 minutes, then 75% for 30 minutes and then the normal rate of flow.

I figure I’ll be out of here around 2 or 2:30 pm. The Oreos are already consumed.

This time I am in a different section of the infusion center – the one that I could see through the window from my last fiasco of infusion. I’m in 7b this time.

As you can see from the photo with me and the cubicle, it’s cold. I wore jeans, long sleeved shirt, socks, shoes, and even then I had to put on a jacket. I declined the pillow and blanket at first but had to ask for them later. Next infusion I’m wearing long johns. I’m not kidding here. My hands are cold! I may bring gloves next time.

The only reaction I seem to have from anything was when Jullianne administered the pre-drug routine. I got a little loopy, as in dizzy, and had trouble focusing. That’s gone now and I”m just waiting for the Taxol drip to end.

What follows next may not make any sense. I started to feel nauseous and notified Jullianne. She checked with the pharmacist as to what to give me since I already had a dose of Zofran. The pharmacist recommended more Pepcid to coat the stomach and apparently Jullianne took it upon herself to contact Dr. Velez who recommended Ativan. Ativan is used as an anti-anxiety drug as well as a anti-nausea drug. When Ativan kicked in, I had no problems.

She stopped the Taxol drip at 2:oo pm and injected the Pepsid and Ativan. I started to feel very good about 15 minutes later. She then zoomed the Taxol into my system and I was out of there by 3:15.

Anyone who seems nauseous is given an Emesis bag. I’ll let you look that one up.

This is the second one they have provided me. The night they took me to the emergency room I got one. Pretty soon I’ll have a collection. Personally, I think they could have called it vomit bag.

At 3:15, Jullianne unplugged me and I headed to the car. I was definitely a little woozy. I may start asking people for rides. I then picked up my this year note cards I designed and proceeded to give out five sets to the people at the surgery center. I’ve mentioned the receptionist and her coworker – each got one. Lorraine and Kathy who have been exceptionally helpful got one each and one of the other nurses that I don’t know her name but came and got me the day the drain was removed and stayed with me got one. Again, I think they all could be empathy trainers for all businesses.

I have to feel positive about this session. It ran 6 hours but will probably be less time eventually. She had to release the Taxol very slowly. She said every session, it would be released more quickly than before. Now, I await the side effects. They could be very mild or very severe. That’s why Dr. Velez game me his phone number so I can text him. For the 9 week period of every Monday (1 more of those) or every Tuesday, I now have 8 more sessions to go. After that, it’s strictly the monoclonal antibody Herceptin.

Jullianne took very good care of me but I bribed her with a King Leo peppermint. Next time I’m gonna have to up my game. Another patient brought his mother’s famous chili recipe. She raved over it as did some of the other nurses. I asked if she does get the recipe I want a copy. Hmmm. Now what can I get her to one up the other guy?

Stay tuned!

20 August 2023

There wasn’t any morning walk today. Just about the time I started to gear up for my Riverland segment, a downpour hit. There was a lot of lightning with the downpour and even after the rain stopped, the thunder didn’t so I punted on the walk. It was a good time to work on the L.A. Times Crossword Puzzle. I never can finish The New York Times puzzle on Sunday but I can sometimes finish the Los Angles version. (I had to cheat and look up a few of the answers on today’s.)

I had my second shower and it’s still a great feeling. There’s no leakage from the insertion. Who knew such a simple pleasure could be so good! I shaved my face and my head. I only have to shave every 3 or 4 days these days, a result of the first chemo in June. What hair I do have on my body is still very fine. All the coarse stuff fell off. It gives you a weird feeling to have only fine hair.

I’m spending some time today figuring out what I’ll need for tomorrow’s infusion of Taxol. I’ll be there 3-4 hours. First, they’ll clear the port then take a blood sample. They’ll have to get a result from the blood test before they can administer the infusion. They want to make sure I have no infections, low or high cell count, etc.

Once I pass the blood test, they’ll put the order in for the infusion with the pharmacist. It depends on how long it takes for the pharmacist on site takes to mix the infusion before they can give it.

They’ll administer the infusion over approximately 2 hours because they want to make sure that I don’t have a reaction to the chemo. If that is OK, they’ll speed it up over the next 9 weeks. By the end of nine weeks, I’ll probably only be at the infusion center for a couple of hours.

After I complete the infusion, they’ll keep me on site for another 30 minutes to an hour to continue to monitor me for immediate side effects.

To combat the boredom of four hours, I’ll take my iPad and read. I also packed my ear buds in case I want to listen to any podcasts or music. I also packed my lap top so I’ll get a head start on tomorrow’s blog.

I learned last time to wear long pants and long sleeved shirt and I also packed a light jacket. They provide heated blankets but when you wear shorts like I did last time, you still freeze. I maybe snuck in some Oreo cookies and some King Leo peppermints for a snack. They provide juices and coffee, so I should be set.

I need to remember to take the anti-nausea medicine tonight and make sure I take another pill after the infusion. Fortunately, nausea wasn’t really been a problem with the first infusion.

A special shout out to Catherine who sent me a beautiful bouquet.

Do I have great friends or what?

Stay tuned!

17 August 2023

You gotta love those 4 am wake ups. I have no idea why but I didn’t fight it. Coffee and breakfast at 4:30 am. I’ll probably crash sometime today but I have a 9:45 am with Dr. Burgers and a 2:30 pm with Dr. Tepper and I need to grocery shop somewhere in between.

You can get a lot done when you get out of bed at 4. I wonder if Dr. Burgers did because I was early for my appointment. They require you to be there 15 minutes before your scheduled appointment and I was there at 9:15 am. I just sat down when the nurse called me back and no more than 2 minutes later Dr. Burgers appeared, 20 minutes before my scheduled appointment.

She briefly looked over my record of fluid levels and said “Let’s get that thing out of you.” She pried the bandage off, snipped a suture with a pair of scissors and slid the tube out. I felt the snip of the suture but didn’t feel anything when the tube came out. She put a temporary bandage on it and gave me the go ahead to shower tomorrow morning. I’ll probably just put a waterproof bandaid on it before showering.

She also cleared me for my first round of new chemotherapy on the 21st. That’s a relief. I want to see how I adapt to the two drug formula as opposed to the four drug that nearly killed me. I exaggerate but not by much – considering it sent me to the emergency room, had me admitted to the hospital over night and damaged my kidneys.

The two drugs are Taxol and Herceptin. Both have a long list of side effects but the two major concerns are Taxol causes diarrhea and Herceptin leads to heart damage. Dr. Velez is giving me smaller doses than normal of Taxol to offset the diarrhea problem and I’ll undergo echocardiograms every 2-3 weeks to monitor any heart damage.

The 2:30 pm appointment with the cardiologist was quick once he came into the room. I think he must have had a serious patient in the room next to mine because I could hear parts of their conversation. He spent around 40 minutes of my schedule with the other patient. I didn’t mind. I’m retired. I play solitaire on my iPhone.

The main reason to check with him was to inform him of my infusions with Taxol and Herceptin. He said he’s only had one patient on Herceptin that had any problems whatsoever. That was news I was glad to hear. He asked about echocardiograms and I explained Holy Cross would do them but if not, I would give him a call. He wanted to see me in two months.

I did manage to get grocery shopping in today to the tune of $180. There were some things I wanted to stock up on and there are some things that Whole Foods doesn’t carry (black-eyed peas for some reason) that Publix does.

There seems to be light at the end of the tunnel with this cancer thing. I just hope it isn’t an oncoming train.

Stay tuned!

14 August 2023

It wasn’t a good night’s sleep nor a good morning. Something was just off with me. I felt nauseuous but fortunately that calmed down after a while. I was even off my usual breakfast and coffee routine of fruit, yogurt and 2 cups. Too eager to get to Dr. Burger’s office I guess and hoping to get the drain removed.

No such luck. She vacillated between removing and keeping but finally decided to wait until Thursday. She was concerned if she took it out too soon, the fluids would simply build up again. The only good news was the most recent bacterial culture came back negative. What I failed to ask is if I will keep my August 21 chemotherapy schedule. I suspect that will be canceled because even if she does take the drain out on Thursday, it incision will not have healed sufficiently. That throws my chemo schedule out of wack.

So, Thursday is a 9:30 am appointment with Dr. Burgers and a 2:30 pm appointment with Dr. Tepper, my cardiologist. Who says there’s nothing to do in old age. You are kept busy with doctors’ visits! You also get to keep your memory sharp by filling out all the online forms they require. I think I preferred it when doctors kept paper records.

On the way back home, I stopped at The Whole Enchilada. I ordered the Happy Gilmore with roasted peppers & onions, jack & cheddar cheese, lettuce, tomato, bam bam sauce. I’m not sure what bam bam sauce is. As usual, the tortilla fell apart around the sandwich and I simply ate the stuffings out. I’m not even sure why they even put it in a tortilla because they all fall apart. Next time I’m there, I’ll order the one that has no tortilla. You just say to the person “Go Naked.”

I used to eat there more often and the food is fresh but for some reason its been a while. The parking there is almost non-existent but since I arrived a few minutes after 11 am, there was only one other car in their minuscule lot.

As I was getting ready to turn down my street, my neighbor, Chris called and asked if I would be home, she wanted to stop by. I told her I was turning into the driveway. About 15 minutes later she shows up in her car with two Publix bouquets in hand and offered me my choice. They were BOGO and she thought I’d like one. Yes! I had just thrown out the last arrangement before she got to my house so it was perfect timing.

I’ll be honest. It’s depressing to keep this drain in. My mastectomy was July 13th. I had a drain inserted that date. It was removed on the 31st. The second surgery was on the 7th of August. Today is the 14th, so that’s 26 total days of a drain with 4 more to go. I keep worrying it will get infected. Just like me to survive the mastectomy but die from septicemia.

__________

A little historical botany. This plant was transported to Jamaica from West Africa by none other than Captain Bligh of Mutiny on the Bounty fame in 1793. The mutiny was in 1789, so this was 4 years after Mr. Christian’s uprising. It’s commonly called ackee or akee but the scientific name honors Captain Bligh, Blighia sapida.

This particular tree grows at the entrance to my subdivision (Flamingo Park) and it’s a rather tall tree next to a Candlenut tree (native of Hawaii) so someone liked exotic plants.

Each leaf has 6-8 leaflets and the flowers are unisexual (monoecious) and are greenish-white in color. The fruit is three-lobed and turns bright red when ripe.

Surrounding the black seeds are fleshy arils that have the texture of scrambled eggs but taste nutty. Caution! The fruit is edible but only if the fruit is perfectly ripe. Otherwise, it is poisonous in all the other phases of development.

The tree is a member of the Sapindaceae family of plants. One member of the family you may have heard of is lychee. Today, it also includes the maple family which previously belonged in the family Aceraceae.

Genus/Species	Common Name	Location
Acer circinatum	Vine Maple	Snoqualmie Falls, Washington
Acer macrophyllum	Bigleaf Maple	Snoqualmie Falls, Washington
Acer negundo	Box Elder	Zion National Park
Acer pensylvanicum	Striped Maple	Great Smoky Mountains National Park
Acer rubrum	Red Maple	Fanning Springs State Park, Florida
Acer saccharium var. grandidentata	Canyon Maple	Zion National Park
Acer spicatum	Mountain Maple	Linville Falls, NC
Aesculus flava	Yellow Buckeye	Linville Falls, NC
Ungnadia speciosa	Mexican Buckeye	Carlsbad Caverns National Park

Stay tuned!

10 August 2023

Yesterday I received the lab report from the surgery on Monday. First, the good news. Everything was negative for malignancy. They sampled all the tissue removed that was causing the inflammation of my left breast – all 83 grams of yellow fatty tissue within a “cystic hemorrhagic cavity” measuring 12x9x4 cm or 432 ml. To speak unscientific, that’s 14.6 ounces of fat and blood or almost 2 cups. As you might guess, when you look up cystic hemorrhagic cavity, most references point to it occurring on ovaries.

You have to laugh at it. What else can go wrong? At 1:30 am this morning I shot upright in bed because I felt a wetness under my left arm. Not only my tee shirt but my top sheet was stained with, not much blood, but mostly sera. Apparently my drain developed a clot in the line and the blood/sera had no where to go but leak out the incision onto my tee shirt and top sheet. Yes, I checked the line before I went to bed and it was clear so it happened sometime during the night.

After clearing the blood clot, I decided to put the compression bandage back on to perhaps keep the leakage around the incision to a minimum but the bandage was so uncomfortable, I had to take it back off. I decided to hell with it and simply put on a clean tee shirt and went back to a bloody bed. When I got up at 5 am, I had a second bloody tee shirt. I started the wash before I made my first cup of coffee. After my second cup of coffee I remade my bed with clean sheets – for now.

I arrived for my 11:45 am appointment with Dr. Burgers and the receptionist was a little surprised. They had forgotten to tell her my appointment had been switched from tomorrow.

Dr. Burgers inspected the drain, did an ultrasound, and said things were looking much better since the surgery. What was removed during the surgery was mostly necrotic fat tissue and some blood clots. She took a sample of blood from the drain and sent it off for analysis.

The area around the surgery is very sensitive and if clothing touches it, it’s like a burning sensation. She decided to write me a script for Gabapentin (Neurontin) which is often used to prevent or control seizures but can also be used to neuropathic pain. She thinks this will take care of the burning sensation. The one side effect she mentioned was drowsiness. I’m not sure I’ll take it after reading some of the other side effects.

It’s not recommended to take Gabapentin if you take anti-depressants or anti-anxiety (I’m on this) medications or antihistamines (I take Allegra for itching).

That now makes 11 scripted drugs I’m on with all but 4 coming with the cancer diagnosis. Fortunately, I don’t have to take most of them daily because they are for infusions which start on the 21st – if Dr. Burgers clears me for infusions.

Sadly, she wanted me to keep the drain. I’ll go back Monday for another post op meeting with her. I’m going to try to catch up on my interrupted sleep this afternoon. I’ll probably wake in time for the afternoon electrical storm and downpour. We’re still under a heat emergency.

Stay tuned.